|
|||||||
|
|
Fillings: The Basics
Determining If You Need A FillingYour dentist may use several methods to determine if you have tooth decay, including: Observation — Some discolored spots on teeth may indicate decay, but not all of them. Your dentist will use other methods in addition to observation. An explorer, a metal instrument with a sharp tip. Healthy tooth enamel is hard and will resist pressure by the explorer. Decayed enamel is softer and the instrument will stick in it slightly. Cavity-detecting dye — This can be rinsed over your tooth. It will stick to decayed areas and rinse cleanly from healthy ones. X-rays — X-rays can help your dentist see decay that doesn't show on the surface. However, X-rays often are not accurate in detecting smaller cavities, and existing fillings or other restorations can block the view of decay. Decay is not the only reason you may need a filling. Cracked or broken teeth, or teeth that are worn from unusual use — Such as nail-biting, tooth grinding (bruxism), or using your teeth to open things — may also need fillings.
Steps To A FillingWhen you visit your dentist to receive a filling, he or she will give you local anesthesia to numb the area. Next, your dentist will remove decay from the tooth, probably with a drill. Air abrasion and lasers also are being used to remove decay, but most dentists still use drills. A drill, or handpiece, uses metal cones called burs to cut through the enamel and remove the decay. There are many shapes and sizes of bur, and your dentist will choose the ones that are right for the size and location of your decay. Initially, your dentist will use a high speed and a sharp bur to cut through the hard enamel. He or she will precisely outline the cavity with the drill. Once the drill reaches the dentin, or second layer of the tooth, the dentist may use a lower speed drill because dentin is softer than enamel. To clean out the decay, your dentist may use a round bur. Throughout the removal process, your dentist will test the area with the explorer to see if all the decay has been removed and may use a cavity-detecting dye as well. Dentists do not use color to judge whether all the decay has been removed. Not all cavities are discolored, and discolored enamel can be healthy. Once all the decay is removed, your dentist will shape the space to prepare it for the filling. Different types of fillings require different shaping procedures to make sure they will stay in place. Your dentist may put in a base or a liner to protect the tooth's pulp (where the nerves are), although this is not done often. The base or liner can be made of composite resin, glass ionomer, zinc oxide and eugenol or another material. Some of these materials release fluoride to protect the tooth from further decay. If your dentist is placing a bonded filling, he or she will etch the tooth before placing the filling. Bonded fillings protect the tooth from sensitivity and reduce the risk of leakage or decay under the filling. Bonding is always done with composite fillings. It may or may not be done with other materials. Etching the tooth makes microscopic holes in the enamel resembling a honeycomb. The holes allow the filling material to bond tightly with the tooth. Your dentist will put phosphoric acid gel on the tooth for about 15 seconds to etch it and then rinse it out and flow the filling material into your tooth. If you are receiving a composite-resin filling, your dentist will stop several times to shine a light on the resin. This cures (hardens) the material and makes it strong. Finally, after the filling is placed, your dentist will use burs to finish and polish it.
After A FillingMany people experience some sensitivity after they receive a filling. The tooth may be sensitive to pressure, air, sweet foods or temperature. Composite fillings often cause sensitivity, but other types of filling material can, too. In most cases, the sensitivity will subside over one to two weeks. Until then, try to avoid anything that causes it. If your tooth is extremely sensitive or your sensitivity does not decrease over about a two-week period, you should contact your dentist's office. It's important to let your dentist know about the sensitivity you are experiencing. The next time you need a filling, he or she may be able to use a different material and make modifications to minimize sensitivity. People vary in their response to different materials, and your dentist has no way of predicting if your tooth will react to a particular material. When you revisit your dentist to talk about the sensitivity, try to describe it as precisely as possible. The information you give will help decide what should be done next. Your dentist may take out the filling and put in a new one, possibly adding a base, liner or desensitizing agent on the tooth as well. If the filling was very deep, you could need a root canal treatment to solve the problem. Besides sensitivity, some people experience pain when they bite down. There are several types of pain, each with a different cause. The first type of pain occurs when you bite, worsening over time. This is caused by a filling that interferes with your bite. Once your anesthetic wears off, you would notice this right away and should contact your dentist. You will need to return to the office to have the filling reshaped. The second type of pain is a very sharp pain that appears only when your teeth touch. This is called galvanic pain and is caused by two metals (one in the newly filled tooth and one in the tooth it's touching) producing an electric current in your mouth. This would happen, for example, if you had a new amalgam filling in a bottom tooth and had a gold crown in the tooth above it. It is possible that you might feel another pain that's similar to a toothache. In other words, your tooth could feel like it still needs a filling. This might occur if your filling is leaking, allowing saliva and other contaminants inside the tooth. Again, you should contact your dentist. Does it feel like other teeth are sensitive or painful now, besides the one that received the filling? This phenomenon is called referred pain. There's probably nothing wrong with your other teeth. They're just receiving signals from the filled tooth and passing them on. Like the sensitivity you may experience, referred pain after a filling has been placed should decrease over one to two weeks. Your dentist polishes the filling after it is placed, but occasionally sharp edges may remain. If you find one, contact your dentist and arrange to have it smoothed as soon as possible to avoid injury to your tongue or mouth.
|
Next